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Gulf War and Health: Updated Literature Review of Depleted Uranium
Services Agency registries were used to assemble the cohort; most subjects served 6-month missions. Each person was matched to the Swedish Cancer Registry, and 99.9% of the subjects could be followed up; this resulted in a cohort of 8,347 military men, 433 military women, 403 civilian men, and 5 civilian women. Person-time was calculated through the end of followup (1999) or until death, emigration, or cancer diagnosis. SIRs were calculated on the basis of cancer incidence in the general population, and adjustments were made for sex, age (5-year age groups), and period. No measurement or modeling for depleted-uranium exposure was included.
There were 34 incident cases of cancer diagnosed during the followup period compared with 28.1 expected in the cohort (SIR, 120; 95% CI, 90-170). Eight cases of testicular cancer were identified in military men compared with 4.3 expected. The authors reported no statistically significantly increased incidence of cancer but recognized that the followup period was too short to assess the long-term risk of cancer.
Nuccetelli et al., 2005
On the basis of reports of possible depleted-uranium–related cancer risk, the Italian Ministry of Defense examined a large portion of the Italian military deployed to the Balkans during December 1995-January 2001. The cohort consisted of about 40,000 soldiers 20-59 years old who had been deployed at least once in that period and contributed about 80,000 person-years. Cancer incidence was calculated for 5-year age groups for all cancers and specific cancers: Hodgkin lymphoma, non-Hodgkin lymphoma, acute lymphocytic leukemia, and solid tumors. SIRs were calculated on the basis of cancer registries for the general Italian male population. No measurement or modeling for depleted-uranium exposure was included.
The overall incidence of cancer was significantly lower than expected. The only cancer that was significantly increased was Hodgkin lymphoma (SIR, 236; 95% CI, 122-436). A limitation of the study is that the followup period was too short to assess cancer outcomes.
Storm et al., 2006
After reports of increased cancer incidence in military personnel deployed to the Balkans, Danish Defence Health Services and the Danish Cancer Society undertook a study of Danish military (Storm et al., 2006). From January 1992 to December 2001, 15,091 persons were deployed to the Balkans. After exclusion of those deployed to other conflicts, those with errors in their files, and those with a previous diagnosis of a cancer, the cohort contained 14,012 people. The entire cohort was followed through December 2002 or until death, emigration, or loss to followup. SIRs were calculated for the personnel by using corresponding incidences in the Danish population.